Payments to private Medicare Advantage plans have exceeded Medicare fee-for-service costs ever since those payments were increased by Congress in 2003. According to a new issue brief, in 2010, payments to such plans exceeded average costs in fee-for-service Medicare nationally by 8.9 percent—a total of $8.9 billion. Under the Affordable Care Act, payments to Medicare Advantage plans will be reduced beginning in 2012, to be more in line with those in fee-for-service Medicare.

March 23rd marked the first anniversary of the signing of the Affordable Care Act. Despite the stormy politics of its first year, the law's initial set of consumer protections and health insurance coverage expansions was welcomed by many American families. In a blog post, Commonwealth Fund president Karen Davis looks ahead to the second year of health reform, when coverage expansion efforts, as well as important measures for quality improvement and cost-control, will ramp up.

Currently, many Americans with disabilities face potential discrimination from health insurance companies based on their health status and health care needs. As explained in a new Commonwealth Fund issue brief, the health reform law will not only enable people with disabilities to secure access to more affordable coverage, it will help ensure that the coverage they purchase is appropriate to their health care needs—and won't leave them at risk for high out-of-pocket costs.

In a new issue brief, Commonwealth Fund researchers shine a light on an especially promising strategy for expanding the capacity of solo and other small physician practices: sharing clinical support services and health information systems with other practices.

In a two-part blog post published on the Foundation Center's Web site, Commonwealth Fund executive vice president and chief operating officer John Craig proposes ways to modernize the 990-PF tax form—which the IRS uses to regulate private foundations. In part one, Craig outlines the problems with the current tax return system for foundations. In part two, he proposes ways to modernize the system to promote transparency and accountability, and "to strengthen the sector's own self-regulatory efforts to ensure effective use of the nation's philanthropic resources." Also see John Craig's essay on this topic for the 2010 Commonwealth Fund Annual Report.

In a Commonwealth Fund–supported study in the new issue of Milbank Quarterly, researchers identified 15 safety practices in aviation that might be applied to health care, from the "sterile cockpit" rule to incentivized no-fault reporting. Read more to learn how these and other practices could help make patients safer.

The range of measures used to assess the quality of nursing home care (The Gerontologist). Most assessments of nursing home quality use a mixture of structural, process, and outcome measures. Based on their review, the authors conclude that improvements in nursing home quality have "likely occurred," but further improvements are needed.

The duration and content of well-child care visits, based on direct observation (Academic Pediatrics). The researchers conclude that "much of what is recommended is not accomplished in well-child care visits and that certain recommended health supervision/anticipatory guidance topics are more consistently left unaddressed."

Better to Best: Value-Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations is a new report focusing on the four elements central to the advance of such organizations—access, care coordination, health information technology, and payment reform. To download the report, which was supported by the Patient-Centered Primary Care Collaborative, The Commonwealth Fund, the Dartmouth Institute for Health Policy and Clinical Practice, and the Milbank Memorial Fund, visit http://www.pcpcc.net/guide/better_to_best.

The latest issue of this newsletter for employers, coalitions, and others interested in promoting value in health care explores health reform's impact on employers, how Boeing cut per capita health costs by 20 percent, and more.

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Mission

The mission of The Commonwealth Fund is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.